Nintedanib

Nintedanib, the active ingredient in Nintedanib, is a tyrosine kinase inhibitor presented as a unknown/oral tablet for oral use. It treats idiopathic pulmonary fibrosis, systemic sclerosis‑associated interstitial lung disease, and non‑small cell lung cancer when used with docetaxel. GNH USA supplies Nintedanib as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, oncology centres and pharmacies worldwide.

Nintedanib is indicated for several fibrotic and oncologic conditions where inhibition of multiple growth factor receptors is therapeutic.

- Idiopathic pulmonary fibrosis: slows disease progression and reduces decline in lung function. - Systemic sclerosis‑associated interstitial lung disease: improves pulmonary function and delays worsening. - Non‑small cell lung cancer (in combination with docetaxel): enhances overall response rate and survival in previously treated patients.

Nintedanib is associated with a range of adverse reactions that vary in frequency and severity.

Common Side Effects: - Diarrhea: frequent, watery stools that may require supportive care. - Nausea and vomiting: mild to moderate gastrointestinal upset. - Decreased appetite: reduced food intake leading to weight loss. - Elevated liver enzymes: transient increases in ALT/AST. - Abdominal pain: discomfort in the upper abdomen.

Serious or Rare Side Effects: - Severe liver injury: jaundice, hepatic failure requiring monitoring. - Bleeding events: gastrointestinal or pulmonary hemorrhage, especially with anticoagulants. - Arterial thromboembolism: risk of heart attack or stroke. - Gastrointestinal perforation: rare but potentially life‑threatening. - Severe infections: opportunistic infections in immunocompromised patients.

Before initiating therapy, clinicians should assess baseline organ function and potential risk factors.

- Liver function monitoring: check ALT/AST before and during treatment. - Bleeding risk assessment: evaluate concomitant anticoagulant or antiplatelet use. - Cardiovascular evaluation: consider history of arterial thromboembolism. - Gastrointestinal caution: avoid in patients with active ulcers or recent perforation. - Pregnancy and lactation: avoid use due to unknown safety profile. - Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Nintedanib may interact with other medicines that affect its metabolism or increase bleeding risk.

Major Interactions (Avoid): - Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may raise nintedanib exposure. - Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce efficacy. - Anticoagulants (e.g., warfarin) and antiplatelet agents: increase risk of serious bleeding.

Moderate Interactions (Monitor Closely): - P‑glycoprotein inhibitors (e.g., verapamil): may modestly increase plasma levels. - Non‑steroidal anti‑inflammatory drugs (NSAIDs): add to gastrointestinal bleeding risk. - Other anti‑angiogenic agents: potential additive toxicity on vascular endothelium.